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Health Insurance

Financial and structural characteristics of the public and private programs that cover medical costs. LDI analyzes how to expand and improve coverage through insurance exchanges, employer-sponsored insurance, and public programs.

In 2014, Arkansas and Iowa expanded their Medicaid programs and enrolled many of their adult beneficiaries in commercial Marketplace plans. This study suggests that this “private option” may make it easier for new Medicaid patients to get primary care appointments.

As health care costs increase, consumers are being asked to manage more of their own health care spending. One of the most common ways this is happening is through high deductible health insurance plans.

In PLOS ONE, LDI Senior Fellows Pengxiang Li and Jalpa Doshi examine the impact of the Medicare Advantage Presciption Drug Plan star ratings before and after 2012, when they became tied to bonus payments. Does an increase in a plan’s star rating have a direct impact on concurrent year plan enrollment? What’s the indirect impact (via bonus payments) of star ratings on subsequent year plan enrollment?

This Issue Brief discusses treatments for opioid use disorders and summarizes a new systematic review of economic evaluations of these interventions. The review reveals strong evidence that methadone maintenance therapy is an economically advantageous form of treatment; the economic evidence for buprenorphine and naltrexone treatments is more limited.

In the Journal of Adolescent Health, Alexander Bain and colleagues, including Charlene Wong, Daniel Polsky, Raina Merchant, and David Rubinm, identify the most prevalent and costly inpatient hospitalizations in a national cohort of privately insured young adults since the implementation of the Affordable Care Act. The researchers analyzed 158,777 hospitalizations among 4.7 million young adults from January 2012 to June 2013. They find that the top diagnoses for young adult female hospitalizations were pregnancy related (71.9%) and mental illness (8.9%). The top diagnoses for young...

Price transparency—the ability to know the price of something before buying—is a mainstay of most markets. It has been touted as a way to reduce health care spending by enabling a new breed of cost-conscious consumers to comparison shop for care. A new JAMAstudy suggests that it might not be that simple.

The cost of private health insurance, the main mechanism by which people access and pay for health care, is high and rising. In fact, the average family spends more than $17,000 annually on health insurance premiums (KFF). That is, even when a family consumes no health care, they are buying the equivalent of a base-model Toyota Corolla in health insurance every year.

In Health Affairs, Charlene Wong and colleagues go shopping on the most recent iteration of ACA marketplaces. They find added features to help consumers browse and pick a health plan, including total cost estimators and provider look-up tools. Marketplaces differ in how they estimate out-of-pocket costs and how they display plan choices, although most continue to present plans in premium order.